الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Based on epidemiological data linking low bone mass with increased fracture risk, the WHO developed a BMD definition of osteoporosis as a BMD T-score of 2.5 or more standard deviations below peak bone mass. Evidence that leptin regulates bone turnover through a central nervous system has driven attention towards the potential therapeutic benefits of BB to improve bone mass and strength. Β2-adrenergic receptor-mediated signaling in osteoblasts inhibits bone formation and triggers RANKL mediated osteoclast- genesis and bone resorption. In humans, epidemiological observational studies suggested that users of BB have a higher BMD and/or reduced risk of fractures. Therefore, BB may increase BMD and reduce fracture risk in humans. In this study, we aimed to investigate the efficacy, and clinical outcomes of using selective and non-selective BB in patients with primary osteoporosis and whether have an effect in reducing fracture risk in these patients leading to improving disease state. Patients were followed up for six months to monitor & evaluate the difference in disease progression or regression. This study tested this hypothesis by examining the association between selective or nonselective BB use and fracture risk in elderly osteoporotic patients. In Conclusion: Our study revealed that the use of BB either selective or nonselective resulted in an increase in BMD which was highly significant in NSBB & CSBB compared to the control group. The calculated fracture index was significantly lower in NSBB & CSBB in the three types of fracture risk region either 5-year (non-vertebral fracture risk, HIP fracture risk, and vertebral fracture risk). Furthermore, there was a decrease in bone turnover markers (BTM) measured in the study. The decrease in serum CTX, urine NTX, and urine DPD was significantly lower in NSBB and CSBB group compared to the control group. In addition, there was a statistically significant decrease between BTM within the control group, when mean values were compared before and after six months of follow-up without taking BB. Therefore, the use of BB either (selective or non-selective) may improve osteoporosis disease state via increasing BMD, decreasing FR & decreasing BTM. Moreover, we found that NSBB demonstrated a better effect in improving the FR in the three regions measured. In addition, it showed a significant decrease in BTM, especially s-CTX, compared to the CSBB group. This gives us the indication that NSBB may be better than CSBB in enhancing osteoporosis, especially its beneficial effect in decreasing FR and decreasing s-CTX. After six months of treatment, we discovered a substantial negative correlation between BTM and T-score. However, more studies & clinical trials with a larger number of patients are needed to end debate.